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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Seizures
What is a seizure?
A seizure is a symptom, not a disease. It is caused by a
sudden abnormal electrical discharge in the brain. If the
activity stays in one part of the brain, a part of your
body twitches or jerks. However, if the activity spreads in
your brain, you may lose consciousness and have a grand mal
(total body) seizure.
If you have repeated seizures, your health care provider may
diagnose seizure disorder or epilepsy. This diagnosis means
your provider can find no correctable cause for the seizures
but tests may show abnormal electrical wave patterns in your
brain as the cause of your symptoms.
How does it occur?
A seizure is a symptom associated with many diseases and
conditions, including:
- head injury
- brain injury at birth
- brain infections such as meningitis or encephalitis
- brain tumor
- stroke
- drug intoxication
- withdrawal from alcohol and drugs such as narcotics,
cocaine, tranquilizers, and sleeping pills
- metabolic imbalances.
The 2 most common types of seizures are:
- focal or partial seizures, which begin in a specific area
of the brain but sometimes may spread to involve all of
the brain
- generalized seizures, which seem to involve all of the
brain from the start of the seizure.
These main categories are further divided into 2 types of
seizures based on the pattern of the attack:
- Grand mal: a generalized seizure that starts with a loss
of consciousness and falling down, followed by a brief
period of rigid muscles and a 1- to 2-minute period of
violent, rhythmic jerking. The seizure ends with a few
minutes of deep sleep before you return to consciousness.
You will probably not remember the seizure and be drowsy
for hours after the seizure.
- Petit mal: a short period of staring, fluttering
eyelids, or twitching of facial muscles. Each seizure
may last only 10 to 30 seconds, but hundreds may happen
each day. Usually you do not remember the seizure.
Petit mal seizures usually begin when you are a child.
A nearly constant series of seizures or one prolonged
seizure is called status epilepticus. It can be life
threatening and is treated as a medical emergency.
What are the symptoms?
Symptoms of a seizure can include:
- uncontrollable twitching or jerking of part of the body
(for example, the hand or foot)
- prolonged muscle spasms spreading to the arms and legs
- hallucinations, which may be visual or involve other
senses such as hearing, touch, or taste
- intense feelings of fear or deja vu (the feeling that you
are encountering circumstances or a place that you
previously experienced)
- aura, a peculiar sensation that occurs just before a
seizure (for example, seeing flashing lights or hearing
noises)
- loss of consciousness
- loss of control of your bladder muscles so that you wet
yourself.
How is it diagnosed?
Your health care provider will examine you and take your
medical history. You may have blood tests and one or more
of the following safe and painless tests or scans:
- EEG, which measures electrical activity in the brain
- MRI (magnetic resonance imaging) scan, which uses
magnetism, radio waves, and a computer to produce a
picture of the inside of your head
- CT (computed tomography) scan, in which x-rays are taken
of your brain at different angles and then combined by a
computer.
How is it treated?
The treatment for seizures depends on the cause. Your
health care provider may prescribe an anticonvulsant drug.
This medication will help prevent seizures. Your health
care provider will adjust the dosage to minimize any side
effects from the drug.
If your seizures continue while you are taking medication,
your provider will:
- Check the level of the drug in your blood.
- Make sure you are taking your medication as prescribed.
- Make sure you aren't drinking alcohol or using illegal
street drugs.
- Check to see if you are taking other medicines that may
interfere with the anticonvulsant.
Your friends and family should know first aid for seizures.
When you have a seizure, they should:
- Loosen clothing around your neck.
- Not try to hold you down. You should be allowed to move
freely. Objects should be moved away from you to avoid
injury.
- Not put anything in your mouth, but check for breathing.
(The risk of biting your tongue is less than the danger
of inhaling or being injured by anything put in your
mouth.)
- Not move you during a seizure unless there is danger of
injury.
- If you are vomiting, turn you on your side if possible.
- After the seizure is over, turn you on your side while
you become alert.
- Time how long the seizure lasts. If it lasts more than 3
to 5 minutes or you seem not to be breathing, someone
should call 911 emergency help.
It used to be that having epilepsy or a seizure disorder
meant taking anticonvulsants for the rest of your life.
Seizure specialists are now trying to determine who might
safely try going off seizure medicines. Discuss your
situation with your health care provider to see if or when
you might be able to stop your medicine. Never stop taking
your medicines without first checking with your provider.
How can I take care of myself?
- Follow the treatment prescribed by your health care
provider.
- Eat a nutritious diet and create a balance of work, rest,
recreation, and exercise in your life.
- Wear a medical ID bracelet.
- Tell your supervisor and co-workers at work or your
teachers at school that you may have a seizure. Tell
them what to do if one occurs.
- If your seizures are not well controlled, you should
avoid high-risk sports such as skiing and scuba diving.
Ask your health care provider which sports are safe for
you.
- Avoid high-risk jobs that involve heavy or fast-moving
equipment, heights, bodies of water, or other situations
where you or others might be injured if you have a
seizure.
- Ask your health care provider when you may safely drive a
car again. In some states you must report a history of
seizures when you apply for a driver's license. Check
with your state's Department of Motor Vehicles for
specific rules.
- Keep a positive attitude and develop techniques to lessen
stress.
What can I do to help prevent seizures?
To help prevent further seizures:
- Take your medication as directed.
- Make sure you get enough sleep every night. Getting too
little sleep can be a major cause of seizures if you have
a seizure disorder.
- Avoid alcohol.
- Avoid mood-altering drugs, including stimulants and
sedatives.
- If you start to develop a fever, reduce it promptly with
aspirin or acetaminophen.
- Call your health care provider if you have side effects
from your medicine or if the seizures continue or
increase.
- Keep all of your follow-up appointments with your health
care provider.
For more information, call or write:
Epilepsy Foundation of America
Epilepsy and Seizure Disorder Service
4351 Garden City Drive
Landover, MD 20785
800-332-1000
800-332-2070 (TDD)
Web site: http://www.epilepsyfoundation.org
Answers specific questions from callers, referrals to local
chapters, catalog of educational materials (800-213-5821)
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